Increased thirst, but blood work ok

[DillandAnnie]

Hi everyone,

I posted a little while ago about my 8 year-old cat, Dillard, who had increased thirst after a short round of prednisolone. I am posting here because he has had continued increased thirst and I'm starting to get worried.

Dillard was on the prednisolone for about 2 weeks to see if it would help his allergies. Soon after starting the pred, Dillard began drinking more. I wrote it off as a side effect of the meds, but he tapered off of them about 7 weeks ago and he's still thirsty. He will drink at least several times a day. Before the pred, he would hardly drink any water, since he's on a canned-only diet.

I took him in for a follow-up exam and mentioned my concern to his vet. She did routine blood work and couldn't find anything abnormal. His kidney values were perfectly fine. She told me to just keep an eye on him and repeat the blood work a year from now.

Maybe I'm being too anxious, but something feels off. It could just be that the pred is still not completely out of his system so he's still having this side effect. However, this amount of drinking is not normal for him. Oddly enough, he's not urinating any more than normal.

I'm concerned because I've read about steroid-induced diabetes and Cushing's disease. It sounds like Cushing's is rare, especially in male cats, but my mind is going to the worst place. From what I've read, Cushing's would not be something that would necessarily show up in blood work and tends to develop slowly.

I'm also concerned because when I first started the pred with him, I gave him his first dose and then skipped either one or two days of doses (I think it was only 1 day, but I can't remember exactly). He had another injury occur and I didn't want to stress him out with meds. At the time, I didn't realize that doing this could be dangerous for him. Now I worry that I did damage to his body.

Sorry for the long post. I guess I am just wondering if anyone can offer any wisdom. I do have an appointment scheduled with another vet next week but in the meantime, I'm feeling anxious and running through the worst-case scenarios in my head. Hopefully their second opinion will give us some more information.

Thanks in advance!

 

[HPeters]

When was the followup visit in relation to the tapering of the meds? Was it just after you were completely done the treatment? A couple weeks? Does the vet know it is still a concern for you?
If your still concerned you can measure his water intake vs urine output to show the vet. After 2 months, I should think the drugs are out of his system.
In all honesty there isnt much you can do until the appointment so stay positive!

 

[FeebysOwner]

Hi. Although anything is possible, I don't think the short duration of time Dillard was on pred would result in diabetes or Cushing's. Nor, do I think that abrupt stoppage after only one day of administering the pred would cause permanent damage. Both of these scenarios are much more common with long term pred use. It is a good idea to re-verify whether or not his urine output is greater than before - generally speaking both of the conditions you are concerned about would cause an increase in urination.

I think waiting an entire year to repeat follow up blood work seems a bit long of a time frame, given no one actually knows what is going on. When the vet did bloodwork, did it include a Chemistry Profile (in addition to the standard CBC)? If they tested his thyroid, they would have been able to rule out diabetes. And, I believe with Cushing's, his cortisol level would need to be checked - which is not typically part of the normal set of blood work.

What did your current vet say about your concerns?

 

[DillandAnnie]

Hi. Although anything is possible, I don't think the short duration of time Dillard was on pred would result in diabetes or Cushing's. Nor, do I think that abrupt stoppage after only one day of administering the pred would cause permanent damage. Both of these scenarios are much more common with long term pred use. It is a good idea to re-verify whether or not his urine output is greater than before - generally speaking both of the conditions you are concerned about would cause an increase in urination.

I think waiting an entire year to repeat follow up blood work seems a bit long of a time frame, given no one actually knows what is going on. When the vet did bloodwork, did it include a Chemistry Profile (in addition to the standard CBC)? If they tested his thyroid, they would have been able to rule out diabetes. And, I believe with Cushing's, his cortisol level would need to be checked - which is not typically part of the normal set of blood work.

What did your current vet say about your concerns?

Thanks for your post! I'm happy to hear that you think diabetes and/or Cushing's would be unlikely. That's what I gathered from what I've read, too.

I'll keep an eye on his urine. He's pretty regular with his bathroom usage; he's always gone twice a day and continues to follow that schedule. The only thing that could be different is the actual volume of output. As far as I can see, it looks like the same amount, but I'll continue to monitor.

I thought that waiting a year sounded like too long, too. I did not get a print out of the actual blood work results. I'll request that today and see what exactly they tested. On the list of services rendered, it lists CBC and comprehensive profile.

I usually like our current vet, but have been a bit disappointed the last couple of times I've been in. I was unable to be in the room during the exam and felt like I didn't have much time to talk to her after. She just said to recheck blood work and monitor his drinking. She asked if his food or treats have changed, which they haven't.

Dillard also has small, clear bumps on his mouth that I've had her look at previously and she wrote them off as an allergic reaction. They were actually one of the reasons he started the pred, but they never went away. She a little dismissive of both of this and the drinking.

I was recommended another vet by a friend/former vet tech, so I decided to make an appointment there as well. Hopefully they can offer another perspective.

 

[DillandAnnie]

When was the followup visit in relation to the tapering of the meds? Was it just after you were completely done the treatment? A couple weeks? Does the vet know it is still a concern for you?
If your still concerned you can measure his water intake vs urine output to show the vet. After 2 months, I should think the drugs are out of his system.
In all honesty there isnt much you can do until the appointment so stay positive!

The follow up was just last week, so at least about 6 weeks after his last dose. I also thought that 2 months seemed like enough time for the drugs to be out of his system.

I mentioned my concerns to the vet, and pointed out that this was definitely abnormal behavior since he has never drank water in the past, except on hot days or when we run the A/C for a long time. She didn't seem concerned. I tend to be anxious, so maybe she thinks I'm just overreacting?

I will try to stay positive until next week. My husband keeps reassuring me that he seems healthy otherwise, so hopefully this drinking is just temporary